Kendra S Blackeagle, CRNA | |
920 Church St N, Concord, NC 28025-2927 | |
(704) 403-2715 | |
(704) 699-2453 |
Full Name | Kendra S Blackeagle |
---|---|
Gender | Female |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 18 Years |
Location | 920 Church St N, Concord, North Carolina |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801177621 | NPI | - | NPPES |
4704287475 | Other | MI | MI LICENSE |
1801177621 | Other | NC | INDIVIDUAL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 328087 (North Carolina) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 4704287475 (Michigan) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Carolinas Medical Center-northeast | Concord, NC | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Chs Anesthesia Services Group Inc | 5799007324 | 561 |
Entity Name | Chs Anesthesia Services Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346649415 PECOS PAC ID: 5799007324 Enrollment ID: O20141209001856 |
Mailing Address | Practice Location Address |
---|---|
Kendra S Blackeagle, CRNA 920 Church St N, Concord, NC 28025-2927 Ph: (704) 403-2715 | Kendra S Blackeagle, CRNA 920 Church St N, Concord, NC 28025-2927 Ph: (704) 403-2715 |
Gail Sutton Wooley, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 920 Church St N, Concord, NC 28025 Phone: 704-355-2000 | |
Justice L Edmond, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 920 Church St N, Concord, NC 28025 Phone: 704-403-3000 | |
Terri Crockett, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 920 Church St N, Concord, NC 28025 Phone: 704-783-4235 | |
Mary Jean Detchemendy, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 920 Church St N, Concord, NC 28025 Phone: 704-783-4235 Fax: 704-783-2527 | |
Mr. Michael T Roberts, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 920 Church St N, Concord, NC 28025 Phone: 704-783-1622 Fax: 704-783-2527 | |
Janet Patty, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 920 Church St N, Concord, NC 28025 Phone: 704-783-4235 | |
Virginia Norris Rogers, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 920 Church St N, Concord, NC 28025 Phone: 704-783-4235 |